Question

Endocrine System

How do I know if a hormonal imbalance is causing my lack of energy?

A Answers (1)

  • AMichael Roizen, MD, Internal Medicine, answered

    Your hormones are like the dimmer on your lights - when you need bright lights, you turn on certain hormones to increase the energy sent to that area (like your immune system) and to decrease usage elsewhere. This fine-tuning starts in your hypothalamus and pituitary. Thus, there's a strong association between hormonal issues and energy issues. We primarily see these changes with slow-functioning adrenal and thyroid glands, but small important changes happen minute to minute.
    Stress causes increases in cortisol, which increases sugar in the blood stream and insulin resistance - and that wastes energy in distributing sugar into fat instead of where it is needed to produce ATP. The tough part here is it's not always clear what the best ways are to deal with hormonal issues. Case in point: We physicians aren't sure whether to treat the numbers or to treat the symptoms patients have. We often try to "normalize the numbers from blood tests" even if we're not eradicating the symptoms. The so-called normal range of blood levels for many hormonal levels is defined as the middle, 95 (95?) percent of people with those levels; the top 2.5 percent are considered high, and the bottom 2.5 percent are considered low. Unfortunately, that's just not good math for the individual. It's like saying that if the number that is normal is size six to 11 in shoes, then a six shoe will be okay for you, even if you have a size four foot. Not a good fit, but you'd be wearing a normal sized shoe. Instead, we docs can choose to treat the symptoms as long as the treatment doesn't cause levels that are very abnormal on blood tests.
    Here's one example of why treating the symptoms (what docs learn to do - listen to the patient most importantly) and not just getting a number on your blood test in the 95% range is important: If a T3 (free thyroid hormone level) level up to 1.4 is normal but we have to get up to 1.5 to eradicate your symptoms, then we think we should listen to you and do that, periodically backing off to see if you can be symptom-free with less thyroid hormone. Because when hormones aren't regulated to levels that are right for you, you've got a dimmer that keeps flipping from producing power full time to the [S1] producing power half time. So that lack of thyroid hormone means your energy factories can't use the food you've eaten to efficiently produce those ATPs. That makes you feel tired.

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